Trileptal & Daughter's Irritability
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Q:  Trileptal & Daughter's Irritability

My 15 year old daughter was diagnosed with bi-polar and is being brought up to a thereuptic level of trilipital of 1,200 mg for now.  Anyway when I increase the medication by 150 mg. then to 300mg she becomes more irritable and argumentative, oppositional.  Is this normal?  This is the only medication for right now and I do not know how high of a dose we will be going.  We see our doctor in a week or so.

Dear Ms. K' -- 
Hard to tell what's going on there.  If the dose is still just 300 mg and you're on the way up, I'd generally guess that what you saw in the way of increased irritability was part of her own cycling and it just happened to coincide with the Trileptal getting added (especially if she has fairly frequent episodes of such behavior; if they are rare, and one showed up right after Trileptal was added, then I'd be scratching my head wondering "what's going on here?" and if it happened again or there was a worsening again after the next increase, I'd probably stop and switch to something else.  

If you're already at 1200 and seeing this, the same logic would apply and I'd be planning to move the dose up to see if we could stop such episodes; and again, looking to see if right after the next step up there was an increase in such symptoms, with the same plan as above if so.  

The good news is that your daughter was started on Trileptal.  This means you're working with an up-to-date sophisticated psychiatrist, most likely; so you can probably rely on the interpretations your doc' has offered (by now). 

Dr. Phelps

Published February, 2003


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